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Wednesday, October 17, 2012

Hospital Physician Relationships Revisited

All
essential knowledge relates to existence, or only such knowledge as has an
essemtoa; reltikonship to existence is essential knowledge.

Soren Kieregarrd (1813-1855),ConcludingUnscientific Postscript (1846)

At best, the renew of broken relationships is a
nervous matter.

Brooks Adams (1838-1918), The Education of Henry
Adams

October 18, 2012 -Form time to time, I review my blog hits to to wee what my followers are
reading.The following post is the hot “read” today , by a ratio
of 5:1 over its nearest competitor. I
am not surprised.Hospitals and doctors need each other. As a hospital administrator once
told, me “ You can’t live without doctors
andyou can’t live with them..”

Accountable Care
Organizations, the bonding together of hospitals and physicians into common
entities, so that Medicare can charge bundled or capitated fees for episodes of
care for chronic disease is an integral part of the health reform law.

From the Medicare standpoint, this bonding strategy makes sense. It simplifies
things because one is dealing with fewer large entities rather than thousands
of doctors; it allows more rational budgeting; it makes care protocols easier
to implement; it is a start to phasing out fee-for-service; and it addresses
the growing problem of paying for chronic diseases in an aging population.

But there is a problem. The most prominent of these is simply a matter of
control between hospitals and doctors. Who controls setting the overall fee and
fees for each of the physicians involved? As one physician commented, “ACOs
stands for Accountable Control Organizations.” This is the issue that
contributed to the fall of Physician Hospital Organizations (PHOs), which some
physicians dismissed as HPOs, or Hospital Physician Organizations, meaning that
hospitals were in control.

It is likely ACOs will take many forms, depending on hospital and physician
leadership, on legal barriers, and on the contentiousness and amicability of
existing hospital-physician relationships.

I bring this matter up because I have written or co-authored two recent books
on the subject:

Readers of this blog might want to order a copy from PSR Publications
(www.practicesupport.com). Discounts on bulk quantities of books published are
available to professional associations, corporations, and other qualified
organizations and marketers.

Here is an excerpt from The Seizing Opportunities book
What can a hospital CEO do to influence doctors to become strategic partners
rather than competitors? Well, first, the CEO should understand the essence of
the physician culture.

1. Doctors in a single specialty, though considered conservative and slow
moving, speak from the same page. They know each other well, have similar
practices, have a common language, and unite behind common business purposes.
When uneasy or suspicious of hospital motives, they can move with astonishing
speed to form competing entities.

2. Certain specialists, including heart surgeons, cardiologists, orthopedic
surgeons, and oncologist – the economic lifeblood of most hospitals – are
accustomed to acting decisively in clinical matters. This decisiveness carries
over into business affairs.

3. Doctors are threatened by a hostile business climate and will move quickly
to gain control of their economic and clinical destinies.

4. Doctors pride themselves on being independent Professionals and are
accustomed to acting with dispatch and with inadequate and uncertain
information.

And so forth. In the book, I list 9 other characteristics of the physician
culture that hospital executives should understand about doctors.

Tweet:Compatible
hospital-physician relationships are
essential if health reform is to succeed in improving quality and safety
and reducing costs.

The Health Reform Maze

Buy the Book

Book Description: In this first book in a series of four, Richard L. Reece, MD. provides a unique view of the roll out, and run up, of the Affordable Care Act. Reece shows in this book the progress and facets of ObamaCare's marketers and messengers, as the day approached for the launch of health insurance exchanges - the single most public and problematic portion of the new law. This is a must read for anyone who wants to chronicle this attempt to organize more than one-sixth of the U.S. economy by adding layers of federal government control and regulations.

Reece has been writing about U.S. health care for more than 45 years. His knowledge and experience, added to his keen intellect and gift of subtle humor, make this book a valuable part of anyone's collection.